2nd Trimester
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My insurance makes me mad (vent)
Just got off the phone with them b/c DH is trying to step up our insurance to the next level. The PPO we have now is OK but not great. They have denied us b/c I have a "pre-existing condition" of pregnancy!! They said that they classify pregnancy as a condition that needs treatment so we can't be approved to increase our policy! The kicker that really gets me mad is that the new insurance would approve and then cover Jenny Craig or Weight Watchers if I was overweight as "preventative". So basically I could get coverage if I was just overweight and trying to slim down even though that is obviously "pre-existing" but I can not be pregnant!!!! Really????
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Re: My insurance makes me mad (vent)
I don't know if it's state law; I always thought it was federal. But, at least here, it's illegal for them to consider pregnancy a pre-existing condition.
ETA: from the US Dept of Labor Website:
In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children.
https://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
It is illegal for them to consider pregnancy a pre-existing condition for Employer Group Plans.
However, if they are trying to up their plan and it is not their company's open-enrollment time, that could cause complications.
OP, is this plan you have individually or through on of ya'll's work?
From what you've said, they shouldn't be excluding you because of your pregnancy. It's an Employer Group Plan, and it's open enrollment ... so you have the opportunity to change your plan at will, etc. So even if you were to enroll into a new plan altogether, they couldn't exclude you because of pregnancy either.
Sounds fishy to me. I'm not in HR, and when I worked in Healthcare, I concentrated in Medicare (though we did study exclusions, etc., for licensing). This sounds completely wrong to me. I hope you get this worked out! Or I hope someone else can shed some light on why they're trying to give ya'll the shaft.
when I found out I was pregnant, I started looking into health insurance plans. I'm a full time student, but at the time (before I was pregnant) didn't qualify for any state aid, and couldn't afford the additional $350/month for insurance.
Anyhow, like others have said, applying for an individual policy, they do consider pregnancy to be pre-existing. I called several people, all said the same thing, though it was a 6 month waiting period. I might have been covered for delivery. All said that if I had been enrolled in a GROUP membership, then it would not have been an issue.